Refining the notion of maturing out: results from the national epidemiologic survey on alcohol and related conditions

Development and Validation of the Dutch Social Attunement Questionnaire (SAQ)

The social plasticity hypothesis proposes that social attunement, i.e., the adaptation to and harmonization with one's environment, plays a crucial role in the risk for developing alcohol use disorders (AUDs) during adolescence, whereas in adulthood it paradoxically may make individuals more sensitive to the social pull to reduce drinking. This study aimed to develop a valid measure of social attunement: the social attunement questionnaire (SAQ). A total of 26-items were developed and the questionnaire was completed by 576 Dutch mid to late adolescents and adults over three rounds of online data collection. Using exploratory factor analysis in part of the sample (N = 373), the final questionnaire was reduced to two subscales with a total of 11 items. This structure was confirmed using confirmatory factor analysis in the second part of the sample (N = 203). Results showed that the SAQ has acceptable internal consistency, good measurement invariance to gender, and subscales assessing both cognitive as well as behavioural components of social attunement. In line with expectations on alcohol use settings, SAQ scores were not associated directly with alcohol use, but they were predictive of alcohol use when taking into account the interaction between perceived peer drinking and age. The SAQ appears suitable for the assessment of social attunement in (young) adult men and women, particularly assessing the role of social attunement in alcohol use settings. Further research is needed to confirm the utility of the SAQ in older adults and a broader variety of social settings.

The Genetically Informed Neurobiology of Addiction (GINA) model

Addictions are heritable and unfold dynamically across the lifespan. One prominent neurobiological theory proposes that substance-induced changes in neural circuitry promote the progression of addiction. Genome-wide association studies have begun to characterize the polygenic architecture undergirding addiction liability and revealed that genetic loci associated with risk can be divided into those associated with a general broad-spectrum liability to addiction and those associated with drug-specific addiction risk. In this Perspective, we integrate these genomic findings with our current understanding of the neurobiology of addiction to propose a new Genetically Informed Neurobiology of Addiction (GINA) model.

Age-related differences in the effect of chronic alcohol on cognition and the brain: a systematic review

Adolescence is an important developmental period associated with increased risk for excessive alcohol use, but also high rates of recovery from alcohol use-related problems, suggesting potential resilience to long-term effects compared to adults. The aim of this systematic review is to evaluate the current evidence for a moderating role of age on the impact of chronic alcohol exposure on the brain and cognition. We searched Medline, PsycInfo, and Cochrane Library databases up to February 3, 2021. All human and animal studies that directly tested whether the relationship between chronic alcohol exposure and neurocognitive outcomes differs between adolescents and adults were included. Study characteristics and results of age-related analyses were extracted into reference tables and results were separately narratively synthesized for each cognitive and brain-related outcome. The evidence strength for age-related differences varies across outcomes. Human evidence is largely missing, but animal research provides limited but consistent evidence of heightened adolescent sensitivity to chronic alcohol's effects on several outcomes, including conditioned aversion, dopaminergic transmission in reward-related regions, neurodegeneration, and neurogenesis. At the same time, there is limited evidence for adolescent resilience to chronic alcohol-induced impairments in the domain of cognitive flexibility, warranting future studies investigating the potential mechanisms underlying adolescent risk and resilience to the effects of alcohol. The available evidence from mostly animal studies indicates adolescents are both more vulnerable and potentially more resilient to chronic alcohol effects on specific brain and cognitive outcomes. More human research directly comparing adolescents and adults is needed despite the methodological constraints. Parallel translational animal models can aid in the causal interpretation of observed effects. To improve their translational value, future animal studies should aim to use voluntary self-administration paradigms and incorporate individual differences and environmental context to better model human drinking behavior.

The differential effects of verbal sexual coercion and forcible sexual assault on alcohol use and consequence trajectories in the first year of college

OBJECTIVE

Verbal sexual coercion (VSC) is the most prevalent and pervasive form of sexual victimization that women experience, yet the long-term harmful effects of this type of experience are unknown. The current study examined the effects of verbal sexual coercion versus forcible sexual assault (FSA) on alcohol use and alcohol consequences, two deleterious outcomes that have been linked to sexual victimization.

METHOD

In a sample of college women (N = 649), lifetime history of VSC and FSA were examined as predictors of trajectories of alcohol outcomes with latent growth models. Participants were assessed at six timepoints over their first year of college, a critical transition period of increased risk for both alcohol use and trauma exposure. We also examined the influence of victimization characteristics, such as relationship to the perpetrator and revictimization experiences in these associations.

RESULTS

VSC experiences were predictive of higher levels of alcohol use and alcohol-related consequences (i.e., intercept). This risk was sustained throughout the first year of college. VSC experiences did not predict changes (i.e., slope) in alcohol outcomes over this time. In contrast, FSA was not predictive of either initial level or change in alcohol use and consequences over time.

CONCLUSION

Findings highlight the importance of distinguishing among types of coercive experiences, as they show unique associations with later harmful outcomes. Verbal sexual coercion, common in the lives of young women but often overlooked in the extant literature, is associated with substantial negative impact during the first year of college. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Not all symptoms of alcohol dependence are developmentally equivalent: Implications for the false-positives problem

OBJECTIVE

Recent studies have examined the extent to which alcohol dependence (AD) criteria prospectively predict the course of AD. Critically, these studies have lacked a developmental perspective. However, the differential performance of criteria by age might indicate overendorsement in younger individuals. The current study examined AD criteria in terms of persistence and prediction of AD course and alcohol use by age in order to identify criteria that are likely to be overly endorsed by younger individuals.

METHOD

The current study used longitudinal data from the National Epidemiologic Survey on Alcohol and Related Conditions to depict age differences in rates of new onset, recurrence, and persistence for each AD criterion, thereby showing how these three factors contribute to the overall age-prevalence curve of each criterion. Additionally, we tested age moderation of the predictive association between each criterion at baseline and new onset, recurrence, and persistence of syndromal AD.

RESULTS

Some criteria (particularly, persistent desire or unsuccessful efforts to cut down or control drinking, and drinking despite physical/psychological problems) are both less persistent and less predictive of AD course among younger adults compared to older adults.

CONCLUSIONS

These findings raise the possibility of elevated rates of false-positive AD among younger adults and suggest ways to improve the assessment of AD criteria. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Late- and Typical-Onset Heroin Use Among Older Adults Seeking Treatment for Opioid Use Disorder

OBJECTIVE

Analyze 10-year trends in opioid use disorder with heroin (OUD-H) among older persons and to compare those with typical-onset (age <30 years) to those with late (age 30+) onset.

DESIGN

Naturalistic observation using the most recent (2008-2017) Treatment Episode Data Set-Admissions (TEDS-A).

SETTING

Admission records in TEDS-A come from all public and private U.S. programs for substance use disorder treatment receiving public funding.

PARTICIPANTS

U.S. adults aged 55 years and older entering treatment for the first time between 2008 and 2017 to treat OUD-H.

MEASUREMENTS

Admission trends, demographics, substance use history.

RESULTS

The number of older adults who entered treatment for OUD-H nearly tripled between 2007 and 2017. Compared to those with typical-onset (before age 30), those with late-onset heroin use were more likely to be white, female, more highly educated, and rural. Older adults with late-onset were more likely to be referred to treatment by an employer and less likely to be referred by the criminal justice system. Those with late-onset were more likely to use heroin more frequently but less likely to inject heroin than those with typical-onset. Those with typical onset were more likely to receive medication for addiction treatment than those with late-onset.

CONCLUSION

Late-onset heroin use is increasing among older U.S. adults. Research is needed to understand the unique needs of this population better. As this population grows, geriatric psychiatrists may be increasingly called upon to provide specialized care to people with late-onset OUD-H.

Longitudinal changes in alcohol use and binge-drinking among young-adult college students: Analyses of predictors across system levels

BACKGROUND

Longitudinal research regarding young-adult college student alcohol use behaviors is needed to identify risk factors and inform interventions, particularly with regard to binge-drinking.

METHODS

Data from 3,418 US college students (aged 18-25) in a two-year, six-wave panel study (64.6% female, 63.4% White) were used to examine alcohol use and binge-drinking trajectories, as well as predictors of differing trajectories across individual (sociodemographics, depressive symptoms, ADHD symptoms, early-onset substance use), interpersonal (adverse childhood events, social support, parental substance use), and community factors (college type, rural/urban).

RESULTS

Baseline alcohol use was associated with being White, higher parental education, early-onset use of alcohol, cigarettes, and marijuana, greater social support, parental alcohol use, attending private institutions, and rurality (p's < 0.01). Greater alcohol use over time was predicted by being White and attending private institutions (p's < 0.01). Multivariable regression indicated that predictors of binge-drinking at any assessment included older age, sexual minority, greater ADHD symptoms, early-onset substance use, parental alcohol use, attending private institutions, and rurality (p's < 0.01). GMM indicated 4 binge-drinking trajectory classes: Dabblers (89.94% of the sample), Slow decelerators (7.35%), Accelerators (1.86%), and Fast decelerators (0.84%). Fast and Slow decelerators were older; Dabblers and Fast decelerators were more likely female; Accelerators reported more depressive symptoms; Dabblers were less likely early-onset substance users; and those from rural settings were more likely Slow decelerators vs. Dabblers (p's < 0.05).

CONCLUSIONS

Intervention efforts should be informed by data regarding those most likely to drink, binge-drink, and escalate use (e.g., Whites, men, early-onset users, parental use, private college students, rural).

Racial/Ethnic Differences in 30-Year Trajectories of Cannabis Use among Males

Background: Given that cannabis is the most commonly used illicit substance in the US, continuous research on patterns of cannabis use over the life course can help to ensure progress towards improving public health and reducing health inequalities across race/ethnicity. Thus, we examine racial/ethnic differences in cannabis use trajectories among males across two overlapping stages of the life course. Methods: We use data from two companion studies, the Rochester Youth Development Study (RYDS - a longitudinal cohort study that followed participants from adolescence into adulthood), and its intergenerational extension - the Rochester Intergenerational Study. For Life Stage 1, we consider cannabis use during the transition from adolescence to adulthood (spanning ages 13 to 33; 439 Black, 128 White, and 125 Hispanic males). Among these males who became fathers, we consider cannabis use during fatherhood (Life Stage 2 -spanning the period of time when their firstborn child was between the ages of 7 and 17-217 Black, 55 White, and 56 Hispanic males). Ordinal generalized estimating equations were specified to examine cannabis use trajectories during both stages of the males' lives. Results: No significant differences in cannabis use as a function of racial/ethnic group were found during the transition from adolescence to adulthood (Life Stage 1). All groups had a peak of cannabis use in the early to mid-20's followed by a decline in use. During fatherhood (Life Stage 2), cannabis use was stable for all groups, but Black fathers reported more frequent cannabis use on average than Hispanic fathers. Conclusions: The increase in cannabis use well past adolescence for all groups suggests the potential importance of intervention initiatives during the transition to adulthood. The more frequent use of cannabis by Black fathers warrants further study given the impact parental cannabis use can have on offspring.

The phenotype of recovery IV: Delay discounting predicts perceived stress and a chance locus of control in individuals in recovery from substance use disorders

OBJECTIVE

Understanding individuals who are successful in recovery from substance use disorders will help to inform treatments and preventative measures. Stress has been shown to be associated with both substance use and relapse. Delay discounting is associated with risk of substance use; it is predictive of treatment outcomes and maintained abstinence. Associations between perceived stress, beliefs about locus of control, and delay discounting have yet to be assessed in individuals in recovery from substance use disorder.

METHODS

Data from 93 individuals in recovery from substance use recruited from the International Quit and Recovery Registry (IQRR) were analyzed. Individuals completed the adjusting amount delay discounting procedure to obtain delay discounting rates. Level of perceived stress was assessed by the Perceived Stress Scale (PSS). An individual's belief about locus of control was assessed using the Internality, Powerful Others and Chance Scale (IPCS).

RESULTS

Delay discounting was a significant predictor of perceived stress and scores associated with beliefs about a Chance locus of control (i.e., belief that events that occur in an individual's life are because of chance or luck), even after controlling for demographic characteristics. Time in recovery was also predictive of levels of perceived stress; this relationship was mediated by delay discounting.

CONCLUSION

The present study indicates that delay discounting can predict perception of stress and beliefs about a chance locus of control in individuals in recovery. This information may help understand, identify, and assist individuals whomay need different, new, or more intensive interventions for their substance use disorder.

Epidemiology of Recovery From Alcohol Use Disorder

Almost one-third of the U.S. population meets alcohol use disorder (AUD) criteria on a lifetime basis. This review provides an overview of recent research on the prevalence and patterns of alcohol-related improvement and selectively reviews nationally representative surveys and studies that followed risk groups longitudinally with a goal of informing patients with AUD and AUD researchers, clinicians, and policy-makers about patterns of improvement in the population. Based on the research, alcohol use increases during adolescence and early adulthood and then decreases beginning in the mid-20s across the adult life span. Approximately 70% of persons with AUD and alcohol problems improve without interventions (natural recovery), and fewer than 25% utilize alcohol-focused services. Low-risk drinking is a more common outcome in untreated samples, in part because seeking treatment is associated with higher problem severity. Sex differences are more apparent in help-seeking than recovery patterns, and women have lower help-seeking rates than men. Whites are proportionately more likely to utilize services than are Blacks and Hispanics. Improving recovery rates will likely require offering interventions outside of the health care sector to affected communities and utilizing social networks and public health tools to close the longstanding gap between need and utilization of AUD-focused services.

Electronic nicotine delivery system use is related to higher odds of alcohol and marijuana use in adolescents: Meta-analytic evidence

Research suggests that electronic nicotine delivery system (ENDS) use is associated with other substance use in adolescents; however, the magnitude of this association and whether this differs between adolescents and adults is not yet well understood. This meta-analysis aimed to quantify the extent to which ENDS use is associated with alcohol and marijuana use among adolescents and to compare the odds across adolescent samples and a comparison group of adult samples. A comprehensive literature review was conducted examining the relationship between ENDS use and alcohol (adolescent k = 40 from 19 independent studies; adult k = 35 from 12 independent studies) and marijuana (adolescent k = 24 from 14 independent studies; adult k = 6 from 3 independent studies) use. Adolescents who use ENDS had greater odds of reporting co-occurring alcohol use (OR = 4.50, p < .001), particularly binge drinking (OR = 4.51), and marijuana use (OR = 6.04, p < .001) than adolescent who did not use ENDS. Adults who use ENDS were also more likely to use alcohol (OR = 1.57, p < .001) and marijuana (OR = 2.04, p < .001) than those who did not use ENDS. ENDS use was associated with significantly greater odds of alcohol use (log odds ratio; LOR = 0.96 (OR = 2.61), p < .001) and a trend of greater marijuana use (LOR = 0.93 (OR = 2.53), p = 0.08) in adolescents than in adults. Effects were large in adolescents and small in adults. Findings suggest that ENDS use should be assessed in adolescents in both research and clinical settings. Importantly, ENDS use is strongly associated with co-occurring alcohol or marijuana use in adolescents.

Trajectories of College Alcohol Involvement and Their Associations with Later Alcohol Use Disorder Symptoms

Little is known about what differentiates individuals whose drinking patterns escalate into problematic use following the transition out of college compared to those who learn to drink in a way that is consistent with independent adult roles. Patterns of alcohol use and problems during college may pre-sage progression toward problem drinking in adulthood. The present study sought to examine such patterns in an effort to delineate those at greatest risk. Research has not yet elucidated whether, when, and how these groups diverge. Our results indicate that students who report AUD symptoms one year following graduation reported greater alcohol involvement from the first semester and escalated their involvement with alcohol at a more rapid pace. We observed marked and measurable differences in drinking patterns between those who go on to exhibit AUD symptoms following college and those who do not. A close inspection of these differences reveals that relatively small absolute differences in alcohol consumption add up to large differences in alcohol-related consequences. Thus, markers of longer-term risk are present early in college, and greater escalation of drinking across college is an indicator that intervention is needed. Brief Motivational Interventions could help students to anticipate some of the challenges ahead as they transition from the college environment, as well as the potential deleterious effects of immoderate alcohol use on making a successful transition into adult roles. In addition to the beginning of college, our findings also point to critical periods during which screening and brief intervention may be optimally timed.

Sex differences in substance use from adolescence to young adulthood: Tests of increases in emergent adulthood and maturing out in later young adulthood

INTRODUCTION

This study evaluated sex differences in substance use changes across two transitions: from adolescence (age 17 yrs.) to emergent adulthood (age 23 yrs.), and maturing out from emergent to later young adulthood (ages 28 and 33 yrs.).

METHODS

Four-wave longitudinal data (N = 1004) from adolescence to young adulthood were used and five substance outcomes were assessed (cigarette, alcohol, and marijuana use, heavy drinking episodes (HDEs), and alcohol problems). A longitudinal mixed model tested Sex × Time interactions to determine if sex moderated changes in substance outcomes.

RESULTS

Findings supported both increases in substance outcomes from adolescence to emergent adulthood and decreases in substance outcomes from emergent adulthood to later young adulthood. Sex moderated these relationships, with males increasing their use of substances more than females across the transition from adolescence to emergent adulthood. Findings were partially robust across substance outcomes, although sex specificity was indicated for some substance outcomes (e.g., males' greater acceleration than females for HDEs) for the adolescent to emergent adult interval (from ages 17-23 years) and sex differences in maturing out for some outcomes (e.g., females' matured out earlier than males for cigarette and marijuana use).

CONCLUSIONS

These findings provide support for developmental changes associated with significant increases in substance use during the early twenties and decreases (maturing out) in the late twenties and early thirties. Sex moderated the strength of these relationships and these sex differences may be associated with changes in young adult social roles (e.g., marriage, parenting, and occupational roles).

Maturing Out of Alcohol Use in Young Adulthood: Latent Class Growth Trajectories and Concurrent Young Adult Correlates

BACKGROUND

The purpose of this study was to evaluate intraindividual variation in "maturing out" of alcohol use by using latent class growth trajectories of alcohol use from adolescence (age 17 years) through young adulthood (age 33 years). We also modeled trajectory group differences with regard to concurrent, age-relevant domains of substance use, health (e.g., physical health rating, sleep problems), interpersonal functioning (e.g., conflict with partner), and occupational functioning (e.g., intrinsic motivation).

METHODS

Growth mixture modeling was used with a sample of 1,004 adolescents/young adults, and 3 trajectory groups were identified as follows: (i) a Normative Use group (n = 646) with low alcohol use remaining stable from adolescence to young adulthood; (ii) a Moderate Increase group (n = 300) with moderate alcohol use increasing slowly from adolescence to emergent adulthood (age 23 years) and then decreasing slightly from emergent adulthood to young adulthood (age 33 years); and (iii) a High Increase group (n = 58) with a high, increasing pattern of alcohol use from adolescence to emergent adulthood and then a small decrease in use from emergent adulthood to young adulthood.

RESULTS

At age 33 years, trajectory groups differed, with High and Moderate Increase groups differing significantly from the Normative Use group in current alcohol and other substance use and other risk factors (e.g., friends' alcohol use). Furthermore, the High and Moderate Increase groups differed from the Normative Use group on indicators of health (poorer sleep and more sleep problems), social functioning (higher partner and work-family conflict), and occupational functioning (lower intrinsic work motivation).

CONCLUSIONS

These findings suggest that trajectory group membership in alcohol use from adolescence to young adulthood is associated with the domains of substance use, health, and social and occupational functioning. Furthermore, the findings suggest that maturing out applies primarily to a subset of those individuals at moderate to higher levels of alcohol use.

Predictors of aging out of heavy episodic drinking in emerging adults: a systematic review protocol

BACKGROUND

Heavy episodic drinking (HED) refers to alcohol consumption that exceeds the recommended threshold for a given episode and increases risk for diverse negative alcohol-related consequences. A pattern of weekly HED is most prevalent in emerging adults (i.e., age 18-25). However, rates of HED consistently decline in the mid to late twenties, referred to as 'aging out' or 'maturing out' of HED. Although many individual studies have followed changes in drinking behaviour over the transition to adulthood, there has yet to be a systematic review to identify consistent factors contributing to risk (i.e. failure to age out) and protection (i.e. successful aging out). The objective of this review will be to summarize and critically appraise the literature on factors contributing to aging out of HED among emerging adults.

METHODS

A systematic search of observational cohort studies following drinking behaviours in age cohorts overlapping with the emerging adulthood period will be conducted in MEDLINE, EMBASE, PsychInfo, and CINAHL. Two independent reviewers will evaluate identified studies for inclusion eligibility, extract study data, and assess the quality of included studies. Primary outcomes will be quantity/frequency of alcohol use (e.g. drinks/week) and severity of alcohol-related problems. Predictors of maturing out of HED will be reported narratively, and where appropriate, random effects meta-analyses will be conducted to provide pooled effect sizes. An evidence map will be created to characterize the overall pattern of findings.

DISCUSSION

This systematic review will provide a timely and warranted summary of published work contributing to understanding aging out of heavy episodic drinking. Our findings will provide critical commentary on the developmental course of HED during the transition from adolescence to adulthood and will be the first review to consider both protective and risk factors for maturing out of frequent binge drinking. By highlighting factors identifying those at-risk for prolonged heavy episodic drinking, our conclusions will have important treatment implications for primary, secondary, and tertiary intervention strategies.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42017078436 .

Desistance and Treatment Seeking Among Women With Substance Use Disorders

Addiction rates are rising faster among women than men. However, women with substance use disorders are less likely to enter treatment than males. This study seeks to understand how turning-point events and other maturational processes affect "life course persistent" women's motivations for seeking treatment for their disorder. We conducted semi-structured in-depth interviews with 30 women who were receiving treatment for addiction using thematic analysis. Recurring themes were as follows: experiences of rock-bottom events prior to entering treatment, feeling "sick and tired" in regard to both their physical and mental health, and shifting identities or perceptions of themselves. We discuss the importance of motivating shifts in identity to prevent women from entering treatment as a result of more traumatic mechanisms as well as the possibility of intercepting women with substance dependence and chronic health conditions in primary care or hospital settings with the aim of encouraging treatment.

Marijuana use among US tobacco users: Findings from wave 1 of the population assessment of tobacco health (PATH) study

BACKGROUND

With an increase in marijuana use among adults in the United States (US), understanding the potential impact of marijuana use on tobacco use and associated behavioral and health consequences, including respiratory conditions, is necessary.

METHOD

Survey responses from Wave 1 of the nationally representative Population Assessment of Tobacco and Health (PATH) Study were used to assess tobacco use and marijuana use among non-current tobacco users (n = 17,952) and current established tobacco-users classified as: cigarette only users (n = 8689), e-cigarette only users (n = 437), cigar only (traditional, cigarillo, or filtered) users (n = 706), hookah only users (n = 461), smokeless tobacco only users (n = 971), cigarette + e-cigarette users (n = 709), and users of multiple tobacco products (n = 2314).

RESULTS

When compared to non-current tobacco users, each tobacco user group except smokeless only users had higher odds (odds ratios ranging from 3.86-8.07) of reporting current marijuana use. Among current tobacco users, higher levels of tobacco dependence did not explain the relationship between tobacco use and marijuana use. Additionally, concurrent marijuana use was associated with lower odds of attempts to quit tobacco (OR = 0.86, 95% CI = 0.79, 0.94, p < 0.001) and a higher probability (OR = 1.35, 95CI = 1.21, 1.51, p < 0.01) of reporting a history of respiratory disease.

CONCLUSIONS

The association between concurrent use of tobacco and marijuana and higher tobacco dependence and lower rates of quit attempts suggests the potential for sustained tobacco use and deleterious health effects. Further, marijuana use may represent an additive risk for respiratory harm among concurrent users of tobacco and marijuana.

Parental Divorce and Family History of Alcohol Disorder: Associations with Young Adults' Alcohol Problems, Marijuana Use, and Interpersonal Relations

BACKGROUND

This study used prospective data from 706 young adults to evaluate the impact of parental divorce and family history of alcoholism (FH+) on the outcomes of offspring alcohol problems, marijuana use, and interpersonal relationships with parents.

METHODS

Assessments of parental divorce were based on parent reports, and young adult outcomes were collected from an offspring cohort (n = 706; X age = 33.25 years; females = 53%) via computer-based individual interviews (CAPI and ACASI). Family history of alcohol disorders for parents was based on assessments by mothers, fathers, and young adults.

RESULTS

Parental divorce significantly predicted marijuana use but not alcohol problems. Maternal, but not paternal, alcoholism also significantly predicted marijuana use. Two-way interactions indicated that sex moderated several of the relationships. For example, among those with divorced parents, daughters reported higher levels of conflict with fathers than sons, and sons reported lower levels of maternal support than daughters. Paternal alcoholism was also associated with higher levels of alcohol problems among sons relative to daughters. There was also a significant 2-way interaction between divorce status and maternal alcoholism indicating that young adults who experienced both maternal alcoholism and parental divorce had the highest levels of marijuana use.

CONCLUSIONS

These findings highlight the role that parental divorce and FH+ have on alcohol problems, marijuana use, and interpersonal relationships in young adulthood, and how sex may moderate some of these more nuanced relationships.

Adolescent resilience to addiction: a social plasticity hypothesis

The prevalence of substance use disorders is highest during adolescence; however, many adolescents experience a natural resolution of their substance use by early adulthood, without any formal intervention. Something appears to be unique and adaptive about the adolescent brain. In this Review, we examine the roles of the social environment and neurocognitive development in adolescents' natural resilience to substance use disorders. At present, little is known about the neurocognitive mechanisms that underlie this adaptive phenomenon, since neurodevelopmental studies have mainly focused on the risk side of the substance use equation: escalation of substance use. To provide a framework for future studies, we put forth a social plasticity model that includes developmentally limited enhanced social attunement (ie, the need to harmonise with the social environment), affective processing, and brain plasticity, which underlie adolescents' capacity to learn from and adapt to their constantly evolving social environments.

The natural history of risky drinking and associated harms from adolescence to young adulthood: findings from the Australian Temperament Project

BACKGROUND

We aimed to describe the natural history of heavy episodic drinking (HED) and associated harms from adolescence to young adulthood in a large Australian population cohort study.

METHOD

The Australian Temperament Project consists of mothers and babies (4-8 months) recruited from Infant Welfare Centres and followed every 2 to 4 years until age 28 years. Analyses were based on data from 1156 young people (497 male; 659 female) surveyed repeatedly at ages 16, 18, 20, 24 and 28 years. We used dual processes latent class growth analysis to estimate trajectories of HED and associated harms, employing a piecewise approach to model the hypothesized rise and subsequent fall across adolescence and the late twenties, respectively.

RESULTS

We identified four sex-specific trajectories and observed little evidence of maturing-out across the twenties. In males, a normative pattern of increasing HED across the twenties with little related harm was observed (40% of the male sample). Early and late starter groups that peaked in harms at age 20 years with only minor attenuation in binging thereafter were also observed (6.1% and 35%, respectively). In females, a normative pattern of increasing, but moderate, HED with little related harm was observed (44% of the female sample). Early and late starter groups were also identified (18% and 17%, respectively); however, unlike males, the female late starter group showed a pattern of increasing HED and related harms.

CONCLUSIONS

Continued patterns of risky alcohol use and related harms are apparent for both males and females across the twenties.

Trajectories of Substance Use Disorder in Youth After Detention: A 12-Year Longitudinal Study

OBJECTIVE

To identify trajectories of substance use disorders (SUDs) in youth during the 12 years after detention and how gender, race/ethnicity, and age at baseline predict trajectories.

METHOD

As part of the Northwestern Juvenile Project, a longitudinal study of 1,829 youth randomly sampled from detention in Chicago, Illinois from 1995 through 1998, participants were reinterviewed in the community or correctional facilities up to 9 times over 12 years. Independent interviewers assessed SUDs using the Diagnostic Interview Schedule for Children 2.3 (baseline) and the Diagnostic Interview Schedule IV (follow-ups). Primary outcome was a mutually exclusive 5-category typology of disorder: no SUD, alcohol alone, marijuana alone, comorbid alcohol and marijuana, or "other" illicit ("hard") drug. Trajectories were estimated using growth mixture models with a 3-category ordinal variable derived from the typology.

RESULTS

During the 12-year follow-up, 19.6% of youth did not have an SUD. The remaining 81.4% were in 3 trajectory classes. Class 1 (24.5%), a bell-shaped trajectory, peaked 5 years after baseline when 42.7% had an SUD and 12.5% had comorbid or "other" illicit drug disorders. Class 2 (41.3%) had a higher prevalence of SUD at baseline, 73.8%. Although prevalence decreased over time, 23.5% had an SUD 12 years later. Class 3 (14.6%), the most serious and persistent trajectory, had the highest prevalence of comorbid or "other" illicit drug disorders-52.1% at baseline and 17.4% 12 years later. Males, Hispanics, non-Hispanic whites, and youth who were older at baseline (detention) had the worst outcomes.

CONCLUSION

Gender, race/ethnicity, and age at detention predict trajectories of SUDs in delinquent youth. Findings provide an empirical basis for child psychiatry to address health disparities and improve prevention.

Childhood attention-deficit/hyperactivity disorder symptoms and the development of adolescent alcohol problems: A prospective, population-based study of Swedish twins

Children with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of problematic alcohol and other substance use in adolescence. This study used data from an ongoing, prospective, population-based twin study of Swedish children and adolescents to evaluate the extent to which the association between ADHD symptoms and alcohol problems reflects a unique source of genetic or environmental risk related to ADHD versus a broader predisposition to youth externalizing behavior. We used all available data from same-sex monozygotic (MZ) and dizygotic (DZ) twins on ADHD symptoms in childhood (age 9/12; N = 15,549) and alcohol problems in late adolescence (age 18; N = 2,564). Consistent with prior longitudinal studies, the phenotypic association between hyperactive/impulsive ADHD symptoms and alcohol problems was small in magnitude, whereas the association for inattentive symptoms was even weaker. Additive genetic influences explained 99.8% of the association between hyperactive/impulsive symptoms and alcohol problems. Furthermore, we found that the genetic risk specifically associated with hyperactive/impulsive symptoms was attenuated when estimated in the context of externalizing behavior liability during childhood, of which ADHD symptoms were specific expressions. In sensitivity analyses exploring hyperactivity in mid-adolescence, we found a similar pattern of genetic associations. These results are consistent with previous findings of genetically driven overlap in the etiology of ADHD and problematic alcohol use. At least some of this co-occurrence may result from a general predisposition to externalizing behaviors in youth. © 2015 Wiley Periodicals, Inc.

Problematic Drinking Among Postgraduate Students: Binge Drinking, Prepartying, and Mixing Alcohol With Energy Drinks

BACKGROUND

Although problematic alcohol use has been studied extensively in undergraduate students, little is known about problematic drinking among postgraduate students.

OBJECTIVES

This study examined binge drinking, prepartying, and mixing alcohol with energy drinks to determine: (1) the extent to which postgraduate students engage in these drinking behaviors, (2) how postgraduate students differ from undergraduate students in these behaviors, and (3) the demographic risk factors for these behaviors in postgraduate (and undergraduate) students.

METHODS

This study utilized data from n = 695 students (n = 298 postgraduate; n = 397 undergraduate) who participated in the Healthy Minds Study at a large, public university in the Midwestern US.

RESULTS

Past-two-week binge drinking, past-year and past-30-day prepartying, and past-30-day mixing alcohol with energy drinks were reported by 26.2%, 28.6%, 14.9%, and 8.1% of postgraduate students, respectively. Multivariate analyses indicated that postgraduate status was a significant negative predictor of binge drinking and prepartying, and that status interacted with age in predicting prepartying such that the effect of age on prepartying was negative for postgraduate students and nonsignificant for undergraduates. Age was a significant negative predictor of mixing alcohol with energy drinks for all students.

CONCLUSIONS/IMPORTANCE

This study makes a unique contribution to the literature by providing information on problematic drinking in postgraduate students. Although there was evidence of "maturing out," a substantial number of postgraduate students were found to engage in binge drinking and prepartying, and a not insubstantial number of them were found to mix alcohol with energy drinks.

Personality disorders and the persistence of substance use disorders: A reanalysis of published NESARC findings

The purpose of this study was to examine whether published findings regarding the association of personality disorders (PDs) with the persistence of substance use disorders (SUDs) are attributable to an artifact due to time of assessment of the PD. Two previous studies analyzed data from the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and found that Antisocial PD, Schizotypal PD, and Borderline PD are unique predictors of SUDs. However, a design limitation in NESARC (assessment of PDs at different waves) can potentially compromise these findings. To assess the influence of time of assessment of PDs and to identify associations that might be robust to time of assessment, we compared the association of PDs with 2 estimates of SUD persistence that were based on different populations at risk: (a) among those who were diagnosed with SUD at baseline, the proportion who continued to meet full criteria at follow-up ("prediction"); and (b) among those who were diagnosed with SUD at follow-up, the proportion who met full criteria at baseline ("postdiction"). Differences between prediction and postdiction revealed a robust pattern of higher odds ratios for postdiction among PDs assessed at baseline, and lower odds ratios for postdiction among PDs assessed at follow-up. All published significant associations between PDs and persistence of SUDs became nonsignificant in the postdiction analyses, with the exception of obsessive-compulsive PD predicting nicotine dependence persistence. The present results raise serious doubts about the validity of published findings on PDs and SUD persistence from the NESARC. Design limitations in NESARC preclude a direct comparison among PDs measured at different waves.